Dentaltown February 2013 - (Page 126)

hygiene and prevention message board What instruments do you use for cleaning implants? » DEC 2 2012 Hygienetown Message Board > Hygienetown Daily Post > Hygienetown Daily Post > Scaling on Patients with Implants fanderson Member Since: 05/16/12 Post: 1 of 7 t Scaling on Patients with Implants My colleague and I are both very frustrated with the ‘plastic’ instruments available for cleaning implants. What does everyone out there use? Is there something better or should we simply leave them alone? n DEC 2 2012 DebbieThe Paleo Hygienist Member Since: 11/17/07 Post: 2 of 7 The periodontist I work for and I both agree that the plastic instruments are completely worthless and have stopped using them, including the bulky plastic probe and the plastictipped Cavitron insert, which is also too bulky. Since most implants really don’t accumulate much calculus buildup (unless they are in the lower anterior) you’re really just removing plaque from around the gum line and in the sulcus (which can be 3-6mm). I start by using my explorer or regular probe to explore into the sulcus and see if there is plaque and bleeding. If not, I move on and leave it be. If there is bleeding and plaque, I insert my Cavitron tip to flush out the sulcus (some patients with a deeper sulcus require some Oraqix or Cetacaine liquid anesthetic for this). I don’t actually apply any pressure against the abutment, just flush out the area. When calculus is present, it’s typically supra and around a lower anterior implants; again, I use the Cavitron to tap at the calculus and it typically comes right off pretty easily. I honestly don’t worry about the whole fear of putting micro-scratches in an implant abutment (and my boss is not concerned with this either). I’ve seen way more plaque accumulation in a subgingival root concavity that never created an issue than could ever accumulate in the scratch on an implant. Hu-Friedy makes titanium implant instruments that look just like our traditional scalers. Good for plaque removal if the sulcus allows you to get the instrument down there comfortably for the patient, but not the greatest at calculus removal since there is no cutting edge on it. We have some; I use them but also use regular scalers and the Cavitron when needed. n DEC 2 2012 lindadouglas Member Since: 06/09/06 Post: 3 of 7 I use titanium scalers for implants. At the last IFDH symposium, I attended a lecture on perimplantitis by a Swedish implantologist. She said that scratching the implant is not really an issue; it is more important to improve the health of the tissue by effective removal of the deposits. Having said that, I still cannot bring myself to use anything but titanium scalers on implants. n DEC 2 2012 DebbieThe Paleo Hygienist Member Since: 11/17/07 Post: 4 of 7 I had a hard time at first too, but now I do it all the time. Honestly, in our office, we see the predominant cause of peri-implantitis to be retained cement from crown placement! It causes inflammation, pocketing and severe bone loss if not treated ASAP. We always take a radiograph on our implant patients after they have had their implant crown placed by their GP to check for residual cement because it often shows up on the X-ray just like a piece of calculus! My first encounter with this, my boss scheduled a patient with me so I could anesthetize them and scale off the cement. It will (most of the time) scale off like a piece of tenacious calculus, but you definitely need a sharp scaler, the titanium instrument just won’t cut 126 FEBRUARY 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown February 2013

Dentaltown.com Highlights
Howard Speaks: The SWOT Analysis
Professional Courtesy: Get Off the Hamster Wheel
Continuing Education Update
Second Opinion: Predicting the Future of Dental Amalgam Use and FDA Regulation
Nuts & Bolts Full Arch Case Dissected… Tips, Tricks & Stuff
Employee Embezzlement, Not Sure Which One
Corporate Profile: GC America
Sleep Dentistry Section
Product Profile: Sleep Optima
Breathe Easy: The Advent of CPAP
ACSDD Consortium
Sleep Apnea
Townie Meeting 2013 Last Call!
Do-it-Yourself Finance, Part III: Debt
The Most Effective Presentation Process Ever
“Patient Friendly Dentistry” to the Rescue
Does Kissing Affect Oral Health?
Can Groundhog Day Make a Difference?
Top 10 Tips to a Successful Practice Start-up
How to Build Up the Perfect Tooth
Why We See Problems with Teeth Whitening: The Science of Whitening Part IV – Whitening Sensitivity Solutions
Continuing Education: Full-Arch Appliance Use for Nighttime Parafunction Management
Ad Index
In This Issue: Implants Are Growing in Popularity
Perio Reports
Continuing Education: A.I.M. for Implant Success
Scaling on Patients with Implants
Dentally Incorrect

Dentaltown February 2013